Business Office Manager
To timely and accurately credential all licensed professional medical, dental and behavioral health staff.
Qualifications and Requirements:
To perform this job successfully, and individual must be able to perform each essential job duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. This job description in no way implies that these are the only duties to be performed and may be modified, interpreted and/or applied in any way as necessary. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties.
Essential Job Duties:
- Performs all tasks necessary to credential all licensed provider staff.
- Performs Primary Source Verification of all staff required to be credentialed.
- Verifies that all licenses, certifications and credentials are accurate and current.
- Prepares all necessary paperwork required for providers to practice and to receive payment from insurance, private and government agencies.
- Obtains signatures from all providers as needed.
- Ensures that all licenses and credentials do not lapse.
- Provides sufficient time and notification for providers to renew their licensure and credentialing requirements prior to expiration.
- Processes and submits required documents.
- Keeps supervisor informed of any and all challenges to the credentialing process.
- Communicates with payers, agencies and CCHCI staff.
- Communicates with insurance companies to ensure all credentialing requirements are being met and are current for all providers.
- Communicates with private and government agencies to ensure that all requirements are being met and are current for all providers.
- Communicates with providers and licensed professional staff to ensure that all steps necessary to maintain current licensure and credentialing are being taken.
- Communicates with Health Center Management to assist them in responding to request for information regarding licensure and credentialing of providers and licensed professional staff.
- Communicates with supervisor whenever free time is available to assist medical billers.
- Develops and improves skills
- Remains current in all changes to credentialing requirements of payers and agencies.
- Participates actively in routine staff meetings.
- Participates in training related to documentation, coding and billing compliance and updates to the Practice Management Software in order to be able to assist medical billers.
- Participates in collaborative meetings/trainings as available and necessary.
- Improves development through internal and external trainings provided.
- Seeks opportunities for growth and advancement within the department.
Required Education, Experience, Certificates & Licenses:
- High School diploma or GED.
- Any combination of experience and/or education that provides the necessary combination of skills.
- One year of experience in credentialing.
Required Language Skills:
- Ability to comprehend and compose effective instructions, correspondence and communications in English in both oral and written format.
- Bilingual in English and Spanish preferred, but not required.
- Ability to occasionally exert enough force to move objects weighing up to 10 pounds.
- Ability to continuously remain in a stationary position.
- Ability to occasionally move about inside the work place to access files, office machinery, etc.
- Possesses hand-eye coordination and manual dexterity necessary to constantly operate computer, telephone, and other office machinery.
- Possesses close visual acuity necessary to accurately record and view information on a computer monitor, handwritten and typed documents.
- Ability to discern the nature of sounds at a normal spoken volume.
Other Required Knowledge, Skills, and Abilities:
- Ability to add, subtract, multiply and divide in all measure, using whole numbers, common fractions and decimals.
- Ability to compute rate, ratio and percent.
- Ability to gather data in an organized fashion from varied sources.
- Ability to perform variety of assignments requiring independent judgment.
- Ability to deal with challenges involving one or more variables in routine situations.
- Knowledge of billing, medical records, health plans, and community health centers preferred.
- Knowledge of ICD, CPT, and NDC codes preferred.
- Computer literacy required.
- Knowledge of Electronic Health Records preferred.
Work Environment & Conditions:
- Work environment is usually typical of an administrative office setting with no substantial exposure to adverse environmental conditions.
Job Status: Full Time